A Personal Review of the Patient Protection and Affordable Care Act (P.P.A.C.A.)
Would you really like to know what is in the Obamacare bill that has this country in so much turmoil? Is it really as out of touch with reality as the news makes it? Is the country really going to financially meltdown because of this legislation? We've heard the ongoing sensational news, influencing our opinion, along with those numerous Facebook and Twitter posts fraught with high emotions. This has culminated with Congress shutting down the government on October 1, 2013 because the politicians can't find agreement over this piece of legislation.
I've decided to figure this out myself. Mainly because the circus of emotion causing many lives to swirl in so many directions, is in itself unsettling, and I am very curious of what it is really all about.
Much of my job is spent reviewing and summarizing communications and policy into bite size pieces of information for the reader, depicting information in a non biased yet informative way, thereby allowing them to make informed decisions. I'll attempt to do this in my blog over a period of days or weeks since the ACA is a really LONG bill.
By no means, am I an expert or subject matter expert on this legislation, AND if you have any questions or are a bit (or a lot) cantankerous about it, I encourage you to reach out to your insurance company, attorney, hairdresser, Facebook page or butcher for clarification. My goal is to demystify this legislation for me and share it with you.
On the upside, I will provide you a summary of what I found in my research of the Patient Protection and Affordable Care Act.
Do you have a good cup of coffee to sip while reading this? I suggest you get one.
Sec 2711-2714
No lifetime limits to insurance. The insured can't be kicked off health insurance because it cost the insurance company too much. Someone may be removed for fraudulent practices.
A health plan will cover preventative services.
Coverage will be made available for your unmarried child up to age 26.
Sec 2715
A template will be created by the government, no longer than four pages in length, for insurance companies to use in order to provide information regarding their healthcare plans. The information will be readable. If the healthcare provider changes coverage, notifications will be made in a similar format. This way information is consistently provided to the insured in a readable and consistent manner.
Sec 2716
It prohibits employers from providing healthcare to employees on a sliding scale based on salary. All employees will be treated similarly. If Joe pays $200 - Jerry will pay $200.
Sec 2717
Healthcare providers will be able to demonstrate they are ensuring quality of care to include patient education and wellness efforts. In other words, they will need to be able to prove they are taking care of you and at the same time are being efficient about it. They will need to offer ongoing wellness efforts for patients.
Sec 2718
The insurance provider will need to provide an accounting for patient care related costs and non-claim costs AND provide a pro-rated rebate to the plan enrollees if the cost of coverage exceeded premiums paid by the plan participants by 20-25%.
Sec 2719
During an appeals process the health insurance company has to provide the claimant with the records they have regarding care provided.
Sec 2793
The states may be provided monetary grants to establish an ombudsman who will in turn assist the insured in an appeal process with the insurance companies.
Sec 2794
The states will ensure the consumer gets what they paid for and are informed of premium increases.
Sec 1101
Immediate access for the uninsured with pre-existing conditions will be implemented within 90 days of the bill be signed into law.
Sec 1102
Employers providing insurance will be able to get some reimbursement for keeping early retirees on their plans (Retirees not eligible for medicare).
Sec 1103
States will provide information in an internet format to consumers regarding affordable insurance plans. This format will provide comparable cost information on the plans. It will also provide information on how much insurers are spending on non clinical costs.
This is enough for one blog post. I'll continue to provide updates as I plow through this legislation.
Happy Saturday. Diane
If you want to read it for yourself here is the link
http://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf
Oh? 1) One of the most profound documents of the world is the United States Constitution. An 18-page document.
ReplyDelete2) Affordable Healthcare Act: 2,572 page document. It wasn't read ,nor debated, by members of Congress yet, the bill was passed, "...to find out what's in it." Pelosi.
3) Republicans have pressed to debate the matter approximately 40-times. Instead, our 'leadership' refuses to discuss the bill or allow negotiation to alter it's protracted legalese. Excerpt; "Paragraph (2) of section 6724 (d) of such Code, as so amended, is amended by striking "or" at the end of subparagraph (FF) by striking the period at the end of subparagraph (GG) and inserting after subparagraph (GG) the following new subparagraph: (HH) section 6056 c (relating to statements relating to large employers required to report on health insurance coverage."
Jimmy Kimmel confirmed for me, "People are basically S-t-u-p-I-d!" http://www.youtube.com/watch?v=sx2scvIFGjE
My exposure (and knowledge) is derived from newspaper, multiple on-line blogs, the Christian Science Monitor, and one book written by Betsy McCaughey, Ph.D., Constitutional Scholar & former Lt. Governor of New York.